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Head, Face, and Neck
Physical Assessment
57
Nursing
Graduate
01/17/2012

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Cards

Term
Name the cranial bones
Definition
Frontal, parietal (2), temporal (2), occipital
Term
# of facial bones
Definition
14
Term
Parotid glands
Definition
Salivary glands in the cheeks, over the mandible
Term
Submandibular glands
Definition
Salivary glands beneath the mandible at the angle of the jaw
Term
Sublingual glands
Definition
Salivary glands that lie in the floor of the mouth
Term
Preauricular lymph nodes
Definition
in front of the ear
Term
Posterior auricular lymph nodes
Definition
superficial to the mastoid process
Term
Occipital lymph nodes
Definition
at the base of the skull
Term
Submental lymph nodes
Definition
midline, behind the tip of the mandible
Term
Submandibular lymph nodes
Definition
halfway between the angle and the tip of the mandible
Term
Jugulodigastric lymph nodes
Definition
under the angle of the mandible
Term
Superficial cervical lymph nodes
Definition
overlying the sternomastoid muscle
Term
Deep cervical lymph nodes
Definition
deep under the sternomastoid musle
Term
Posterior cervical lymph nodes
Definition
in the posterior triangle along the edge of the trapezius muscle
Term
Supraclavicular lymph nodes
Definition
just above and behind the clavicle
Term
Posterior fontanel
Definition
Triangle shaped, measures 1cm, closed by 1-2 months
Term
Anterior fontanel
Definition
Diamond shaped, 2.5cm x 2.5cm, closes between 9 months to 2 years
Term
Normocephalic
Definition
round, symmetric skull that is appropriately related to body size
Term
Lymphadenopathy
Definition
enlargement of the lymph nodes (>1cm) from infection, allergy, or neoplasm
Term
Palpation of lymph nodes -- Normal finding
Definition
May be palpable in young, heathy people; feel moveable, discrete, soft, and non-tender.
Term
Palpation of lymph nodes -- Acute infection
Definition
Nodes are bilateral, enlarge, warm, tender, firm but freely moveable.
Term
Palpation of lymph nodes -- Neoplasm
Definition
Nodes are hard, unilateral, non-tender, and fixed.
Term
Palpation of lymph nodes -- Hodgkin's Lymphoma
Definition
painless, rubbery, discrete nodes that gradually appear
Term
Palpation of lymph nodes -- HIV
Definition
enlarged, firm, non-tender, and mobile; often associated with occipital node enlargement
Term
Tracheal deviation -- to UNAFFECTED side
Definition
Occurs with aortic aneurysm, tumor, unilateral thyroid enlargement, and pneumothorax
Term
Tracheal deviation -- to AFFECTED side
Definition
Occurs with large atelectasis, pleural adhesions, or fibrosis
Term
Tracheal tug
Definition
A rhythmic downward pull that is synchronous with systole and occurs with aortic arch aneurysm
Term
Palpation of thyroid gland
Definition
Normally not palpable; check for enlargement, consistency, symmetry, tenderness, and presence of nodules; may hear bruit when auscultated.
Term
Newborn head circumference
Definition
32-38cm; 2cm larger than chest circumference.
Term
Caput succedaneum
Definition
Edematous swelling and ecchymosis of the presenting part of the head; caused by birth trauma; extends across suture lines; gradually resolves.
Term
Cephalhematoma
Definition
A subperiosteal hemorrhage which is the result of birth trauma. It is soft, fluctuant, and well defined; covers only one cranial bone; it's reabsorbed durin ght efirst few weeks of life; risk for jaundice as RBCs in the hematoma are broken down.
Term
Palpation of fontanels -- Normal finding
Definition
Firm, slightly concave, and well-defined.
Term
Palpation of fontanels -- Abnormal findings
Definition
Increased intracranial pressure --> tense or bulging fontanel; may observe pulsations.

Dehydration/malnutrition --> depressed and sunken fontanels

Hydrocephalus --> delayed closure or larger-than-normal fontanel.

Microcephaly --> small fontanel, early closure
Term
Tonic neck reflex
Definition
When supine and head is turned to one side, extension of same arm and leg, flexion of opposite arm and leg; disappears between 3-4 months.
Term
Chloasma
Definition
Blotchy hyperpigmentation over cheeks and forehead during pregnancy.
Term
Thyroid gland -- Pregnancy
Definition
May be palpable normally during pregnancy
Term
Hydrocephalus -- Percussion
Definition
Resonant "cracked pot" sound
Term
Temporal arteries -- Aging adult
Definition
May look twisted and prominent
Term
Hydrocephalus
Definition
Obstruction of drainage of cerebrospinal fluid with increasing ICP. Face appears small, dilated scalp veins, frontal bossing, "setting sun" eyes, "cracked pot" sound on percussion.
Term
"Setting sun" eyes
Definition
Downcast eyes with sclera visible above the iris; occurs with hydrocephalus
Term
Paget's Disease
Definition
Disease of increased bone resorption and formation resulting in softening, thickening, and deformation of bone; occurs in 10% of adults >80; bowed long bones, sudden fractures, frontal bossing, "acorn-shaped" cranium"
Term
Acromegaly
Definition
Excess GH secretion after puberty; enlarged skull and thickened cranial bones; prominent nose and jaw, eybrow ridge, coarse facial features
Term
Torticollis
Definition
Aka "wryneck;" head tilt to one side w/ limited ROM; caused by intrauterine malposition and injury of sternomastoid muscle; may become permanent if not treated
Term
Goiter
Definition
Chronic enlargement of the thyroid gland; indicates iodine deficiency
Term
Pilar cyst
Definition
Aka a "wen;" Smooth, firm, fluctuant swelling on the scalp containing sebum and keratin.
Term
Fetal alcohol syndrome -- facial abnormalities
Definition
Characteristic facies include: narrow palpebral fissures, epicanthal folds, midfacial hypoplasia, micrognathia, ear abnormalities.
Term
Congenital hypothyroidism -- facial abnormalities
Definition
Facies develop by 3-6 months: low hairline, hirsute forehead, swollen eyelids, narrow palpebral fissures, widely spaced eyes, depressed nasal bridge, puffy face, thick and protruding tongue, and dull epression.
Term
Down syndrome -- facial abnormalities
Definition
Upslanting eyes with inner epicanthal folds; flat nasal bridge; small, broad, flat nose; protruding thick tongue; ear dysplasia; short, broad neck with webbing.
Term
Atopic allergies -- facial abnormalities
Definition
Exhausted face, blue shadows below eyes, double or single crease on the lower eyelids (Morgan's lines), central facial pallor, open-mouth breathing; allergic salute and crease.
Term
"Allergic salute"
Definition
Child chronically uses the hand to push the nose up and back to relieve itching and free swollen turbinates
Term
Parkinson Syndrome -- Facies
Definition
"mask-like" face with elevated eyebrows, staring gaze, oily skin, drooling
Term
Cushing Syndrome -- Facies
Definition
Rounded, "moonlike" face; prominent jowls; red cheeks; hirsutism; acneiform rash on the chest
Term
Myxedema
Definition
Puffy, edematous face, periorbital edema, coarse facial features, dry skin and coarse hair
Term
Bell's Palsy
Definition
Lower motor neuron lesion with CN VII paralysis; unilateral; rapid onset; may be caused by HSV. Presents with smooth forehead, wide palpebral fissure, flat nasolabial fold, drooling, and pain behind the ear.
Term
Stroke -- Facies
Definition
Upper motor neuron lesion; Paralysis of the lower facial muscles, but upper half of face is not affected.
Term
Cachectic appearance -- Facies
Definition
Accompanies chronic wasting diseases; sunken eyes, hollow cheeks, and exhausted/defeated expression.
Term
Scleroderma
Definition
"hard skin;" connective tissue disease characterized by chronic hardening and shrinking degenerative changes; hardy shiny skin on forehead and cheeks; thin pursed lips with radial furrowing; absent skinfolds; muscle atrophy; absence of expression.
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